- OBJECTIVE: To establish a statewide network to detect, control, and prevent the spread of carbapenem-resistant Enterobacteriaceae (CRE)
in a region with a low incidence of CRE infection.
DESIGN: Implementation of the Drug Resistant Organism Prevention and Coordinated Regional Epidemiology (DROP-CRE) Network.
SETTING AND PARTICIPANTS: Oregon infection prevention and microbiology laboratory personnel, including 48 microbiology laboratories,
62 acute care facilities, and 140 long-term care facilities.
METHODS: The DROP-CRE working group, comprising representatives from academic institutions and public health, convened an
interdisciplinary advisory committee to assist with planning and implementation of CRE epidemiology and control efforts. The working
group established a statewide CRE definition and surveillance plan; increased the state laboratory capacity to perform the modified Hodge
test and polymerase chain reaction for carbapenemases in real time; and administered surveys that assessed the needs and capabilities of
Oregon infection prevention and laboratory personnel. Results of these inquiries informed CRE education and the response plan.
RESULTS: Of 60 CRE reported from November 2010 through April 2013, only 3 were identified as carbapenemase producers; the cases
were not linked, and no secondary transmission was found. Microbiology laboratories, acute care facilities, and long-term care facilities
reported lacking carbapenemase testing capability, reliable interfacility communication, and CRE awareness, respectively. Survey findings
informed the creation of the Oregon CRE Toolkit, a state-specific CRE guide booklet.
CONCLUSIONS: A regional epidemiology surveillance and response network has been implemented in Oregon in advance of widespread
CRE transmission. Prospective surveillance will determine whether this collaborative approach will be successful at forestalling the emergence
of this important healthcare-associated pathogen.
- Pfeiffer, C. D., Cunningham, M. C., Poissant, T., Furuno, J. P., Townes, J. M., Leitz, A., ... & Beldavs, Z. G. (2014). Establishment of a Statewide Network for Carbapenem-Resistant Enterobacteriaceae Prevention in a Low-Incidence Region. Infection Control and Hospital Epidemiology, 35(4), 356-361. doi:10.1086/675605
|Funding Statement (additional comments about funding)
- This work was funded by a cooperative agreement
with Centers for Disease Control and Prevention Epidemiology and Laboratory
Capacity Program through the Affordable Care Act.